Androgen-related disorder in women

 by Biomechanism 

Androgens may be called “male hormones,” but don’t let the name fool you. Both men’s and women’s bodies produce androgens, just in differing amounts. In fact, androgens have more than 200 actions in women.

The principal androgens are testosterone and androstenedione. They are, of course, present in much higher levels in men and play an important role in male traits and reproductive activity. Other androgens include dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEA-S).

In a woman’s body, one of the main purposes of androgens is to be converted into the female hormones called estrogens.

Androgens in Women

In women, androgens are produced in the ovaries, adrenal glands and fat cells. In fact, women may produce too much or too little of these hormones––disorders of androgen excess and deficiency are among the more common hormonal disorders in women.

In women, androgens play a key role in the hormonal cascade that kick-starts puberty, stimulating hair growth in the pubic and underarm areas. Additionally, these hormones are believed to regulate the function of many organs, including the reproductive tract, bone, kidneys, liver and muscle. In adult women, androgens are necessary for estrogen synthesis and have been shown to play a key role in the prevention of bone loss, as well as sexual desire and satisfaction. They also regulate body function before, during and after menopause.

Androgen-Related Disorders

High Androgen Levels

Excess amounts of androgens can pose a problem, resulting in such “virilizing effects” as acne, hirsutism (excess hair growth in “inappropriate” places, like the chin or upper lip) and thinning hair.

Many women with high levels of a form of testosterone called “free” testosterone havepolycystic ovary syndrome (PCOS), characterized by irregular or absent menstrual periods, infertility, blood sugar disorders, and, in some cases, symptoms like acne and excess hair growth. Left untreated, high levels of androgens, regardless of whether a woman has PCOS or not, are associated with serious health consequences, such as insulin resistance and diabetes, high cholesterol, high blood pressure and heart disease.

In addition to PCOS, other causes of high androgen levels (called hyperandrogenism) include congenital adrenal hyperplasia (a genetic disorder affecting the adrenal glands that afflicts about one in 14,000 women) and other adrenal abnormalities, and ovarian or adrenal tumors. Medications such as anabolic steroids can also cause hyperandrogenic symptoms.

Low Androgen Levels

Low androgen levels can be a problem as well, producing effects such as low libido(interest or desire in sex), fatigue, decreased sense of well-being and increased susceptibility to bone disease. Because symptoms like flagging desire and general malaise have a variety of causes, androgen deficiency, like hyperandrogenism, often goes undiagnosed.

Low androgen levels may affect women at any age but most commonly occur during the transition to menopause, or “perimenopause,” a term used to describe the time before menopause (usually two to eight years). Androgen levels begin dropping in a woman’s 20s, and by the time she reaches menopause, they have declined 50 percent or more from their peak as androgen production declines in the adrenal glands and the midcycle ovarian boost evaporates.

Further declines in the decade following menopause indicate ever-decreasing ovarian function. For many women, the effects of this further decline include hot flashes and accelerated bone loss. These effects may not become apparent until the women are in their late 50s or early 60s.

Treatment for Low Androgen Levels

Combination estrogen/testosterone medications are available for women in both oral and injected formulations. Small studies find they are effective in boosting libido, energy and well-being in women with androgen deficiencies, as well as providing added protection against bone loss. However, the risks from the combination of estrogen and testosterone include increased risk of breast and endometrial cancer, adverse effects on blood cholesterol and liver toxicity.

Testosterone is also an effective treatment for AIDS-related wasting and is undergoing studies for treating premenstrual syndrome (PMS) and autoimmune diseases. Women with PMS may have below-normal levels of testosterone throughout the menstrual cycle, suggesting a supplement may help.

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